The Occipital Condyle (OC) is an integral component of craniovertebral region which is predisposed to a wide array of traumatic, degenerative and neoplastic diseases. Frequent surgical interventions ...of OC are required for successful management of these conditions. Hence a meticulous anatomical knowledge of the OC is vital but variability in morphometric dimensions exist amongst different races and hinder the standardization of measurements.
The aim of this study was to present a morphometric reference database for OC of the Indian population and enable comparisons with other populations.
The study was performed on 228 OC of 114 adult human skulls. Linear measurements of the OC were taken with the help of digital Vernier's Calliper and angular measurements were determined with software Image J.
Mean and standard deviation of the morphometric parameters taken into account were analysed. The comparison of morphometric dimensions of the right and left sides was carried out using Student's t-test and p-value was calculated.
The morphometric analysis of the OC established that mean width was larger (12.97 mm) in Indians population when compared to other races. The anterior and posterior intercondylar distances as well as the distances between the tips of OC and opisthion and basion were observed to be shorter in Indians. We found a significant difference (p=0.01) among the distance between Posterior tip of Occipital Condyle (POC) and basion of the right and left sides. The sagittal condylar angle and sagittal intercondylar angle were found to be greater in our study when compared to other researchers. There existed a highly significant difference (p=0.001) between the sagittal condylar angles of the right and left sides.
The present morphometric study would be valuable for the successful instrumentation of the OC as wider and ventrally oriented OC as well as smaller intercondylar distances may pose challenge to the surgeons during condylectomy. The data of present study offer anatomical reference to the surgeons and would be helpful in designing implants for the OC.
This work examines the changes in precipitation characteristics over the Indian region using the latest high‐resolution CORDEX‐CORE model simulations. Individual RCM (COSMO, RegCM4.7, and REMO) ...experiments, their ensembles, and all RCM ensembles are examined to evaluate their performance using various statistical metrics. It aims to provide a holistic idea for choosing better models for specific analysis (variability, climatology, temporal evolution, indices, etc.) of precipitation distribution over India. The COSMO model experiments show lesser mean bias and have a high correlation coefficient (>0.8) compared to REMO and RegCM4. Each RCM ensemble performs better than its members in representing the spatial patterns of precipitation. Interestingly, the RCM experiments downscaling the forcings from MPI_ESM GCMs and ERA‐Interim outperforms other RCM experiments in the present day period. The probability distribution function reflects that the mean frequency and the intensity of precipitation are best represented in the RegCM4 ensemble. Further, most RCMs agree to a robust increase in low‐intensity rainfall (>0.1–4 mm⋅day‑1) in the future under the RCP8.5 scenario. The intraseasonal variability in terms of active and break spells are best represented in the RegCM4 ensemble. There exists uncertainty in terms of projection of active phases, while all model experiments agree to the decrease in the break phases in the near future compared to the present day. The projected consecutive dry (wet) days and their spells will decrease (increase) over India. The heavy precipitation events are expected to increase (by 18–32 days) along with its contribution (by 14–48%) towards the total precipitation over entire India indicating a possible increase in flooding events in the future. The present‐day ISM characteristics is well captured in the model ensemble compared to individual experiments. The model ensemble indicates towards a robust increase in low‐intensity rainfall in the future. The very heavy precipitation events and its contribution towards total precipitation are increasing in the future.
1. The present‐day ISM characteristics is well captured in the model ensemble compared to individual experiments.2. The model ensemble indicates towards a robust increase in low‐intensity rainfall in the future.3. The very heavy precipitation events and its contribution towards total precipitation are increasing in the future.
Pyramidalis is classified as a vestigial muscle which is frequently present. It is muscle of the anterior abdominal wall. It is thought to tense the linea alba. It has been used as a surgical ...landmark, source of muscle stem cells and in various surgical procedures.
The aim of this study was to describe the morphometry and morphology of pyramidalis muscle in an adult Indian population and its correlation with the clinical significance.
A cadaveric study on 25 formalin fixed cadavers (males-17, females-8) was conducted in context with prevalence, morphology and morphometry of pyramidalis muscle. Statistical analysis was done using the Chi-Square test and student's t-test using SPSS version 23.
The pyramidalis muscle was present in 92% cases, usually bilaterally (72%) than unilaterally (20%) and more frequently in males (94.11%) than in females (87.5%). This study was conducted in Department of Anatomy, Maulana Azad Medical College, New Delhi, India from August 2014 to August 2016. Bilateral asymmetry was reported. The mean length of the muscle in males and females was 52.21±14.32 and 50.13±13.62mm on the right and 53.97±15.11 and 51.22±13.78mm on the left side. No significant gender predominance existed on the right and left-sided pyramidalis lengths. The mean width of the right-sided pyramidalis in males and females was 18.35±5.15 and 17.05±4.99mm and the left-sided was 17.8±4.80 and 16.21±4.23mm without gender dimorphism. The mean thickness of the right-sided pyramidalis in males and females was 4.91±1.33 and 4.53±1.29mm and the left-sided 4.33±1.28 and 4.38±1.27mm without gender differences. The mean pyramidalis-puboumbilical index was 35.15±4.38%, 36.01±4.97% in males and females respectively. No anatomical variations with regard to origin and insertion were seen.
This study provides valuable information on pyramidalis muscle which may help in appropriate understanding of anatomy, functions and clinical significance of the muscle.
The parafollicular cells or clear (C) cells in man are part of neuroendocrine system under Amine Precursor Uptake and Decarboxylation (APUD) cells. Their role in adults has been reputable but in ...foetus is still unclear.
The present study was a baseline study endeavouring to describe the chronological development of the parafollicular cells with particular focus on its correlation with developing human thyroid follicles.
The study was conducted on 10 aborted foetuses (14-28 weeks), procured from the Department of Obstetrics and Gynaecology, Lok Nayak Hospital, New Delhi, India. Serial sections of foetal thyroid gland were generated, stained with haematoxylin and eosin, and immunohistochemistry using the anticalcitonin antibody and examined qualitatively.
In our study, the parafollicular cells were seen as earlier as by 14
week. They became morphologically and functionally mature by 16
week of gestation. The parafollicular cells were getting organized from scattering to parafollicular location then to a more localized area, i.e., intrafollicular along with the follicular development. As the follicles were enlarging, the intrafollicularly located parafollicular cells which was initially present in groups was getting displaced singly between the follicular cells in the same follicle.
The sequential development pattern of the parafollicular cells in relation to developing thyroid follicles was established. This immunohistochemical study also concluded that the parafollicular cells might have higher character to play in the early gestational age such as regulation of ossification in the human foetus.
This study investigated the impact of the Arabian Sea (AS) warming in modulating the winter precipitation over the Indian subcontinent and associated dynamical response such as subtropical jet ...variability using regional climate model, RegCM4.7 of the International Centre for Theoretical Physics (ICTP). In this regard, a control run (RegCTL) is forced by real sea surface temperature (SST), and two sensitivity experiments with uniformly increased SST over AS by 0.45 °C (RegSST45) and 0.90 °C (RegSST90) are performed. The results obtained from a control experiment (RegCTL) are compared with corresponding values from RegSST45 and RegSST90 to assess the warming impact. The model (RegCTL) realistically simulates the circulation features, precipitation, and temperature over the Indian subcontinents in the winter season (November–December-January-February; NDJF) during 2006–2015. It is found that AS warming increases the precipitation over most parts of India during winter. The precipitation response varies with the month (NDJF) and the magnitude of AS warming. In general, precipitation is found to intensify with increasing AS warming over northern India and adjoining south Asian nations like Afghanistan, Pakistan, and some parts of Burma and Nepal. The strengthening of STJ is observed due to AS warming (RegSST45). The strengthening of the subtropical jet (STJ) persists with an intensification of AS warming (RegSST90); however, the magnitude of strengthening is less than RegSST45, which is consistent with the corresponding increase of precipitation over India. Cold wave duration is found to be significantly sensitive to the intensity of AS warming. It is noticed that the AS warming increases the cold wave duration over the northern part of India with major increases over the western Himalayan region.
•RegCM shows resemblance to observation in simulating winter monsoon characteristics and associated mechanisms.•The Arabian Sea warming impact in modulating winter precipitation over the Indian subcontinent is investigated•The precipitation increases over most parts of India during winter that varies with months and levels of warming.•The strengthening of the subtropical jet (STJ) is consistent with the precipitation increase.
Anthropologists have used Coracoclavicular Joint (CCJ), a non-metric anatomical variant in population, as a marker for population migration from prehistoric times to present.
The aim of this ...osteological study was to determine the incidence and morphometry of articular facet of CCJ on conoid tubercle of clavicle in Indian population, as Indian studies are scanty and incomplete.
The study was done on 144 adult human clavicles (76 right and 68 left; 93 males and 51 females) collected from osteology museum in Department of Anatomy, Maulana Azad Medical College, New Delhi, India. The presence of articular facet on the conoid tubercle was determined and Maximum Antero-Posterior (MAPD) and maximum transverse diameter (MTD) was measured by digital vernier calliper. The incidence was compared on the basis of sex, side and with other osteological studies in the world. Statistical analysis was done using the Chi-Square test for nominal categorical data and student's t-test for normally distributed continuous variables in Microsoft Excel 2007 to assess the relationship between the examined variables.
Articular facet on conoid tubercle was found in 8 cases (5.6%). Seven (9.2%) were present on the right side and one (1.5%) on the left side. Seven cases (7.5%) were present in males and one case (2%) was found in females. The facets were generally oval, with MAPD and MTD of 12.28 and 17.17 mm respectively. A significant side variation was present with right sided facet being more common. The left sided facet was more transversely elongated than right. In males, the facets were more elongated antero-posteriorly than in females.
The Indian population showed an incidence of 5.6%, which was comparable to other ethnic groups in world population. The morphometric and side differences could be attributed to the occupational factors and range of movements associated with the CCJ. The CCJ should be borne in mind as a differential diagnosis for thoracic outlet syndrome and in general for shoulder pain.
The Indo-Gangetic Plain (IGP), the source of grains for around 40% Indian population, is known as the breadbasket of India. The Indian Summer Monsoon Rainfall (ISMR) plays a vital role in the ...agricultural activities in this region. The rapid urbanization, land use and land cover change have significantly impacted the region’s agriculture, water resources, and socioeconomic facets. The present study has investigated the observed and regional modeling aspects of ISMR characteristics, associated extremes over the IGP, and future perspectives under the high-emission RCP8.5-scenario. Future projections suggest a 10–20% massive decrease during pre-monsoon (March–May) and earlier ISM season months (i.e., June and July). A significant 40–70% decline in mean monsoon rainfall during the June–July months in the near future (NF; 2041–2060) has been projected compared to the historical period (1986–2005). An abrupt increase of 80–170% in mean monsoon rainfall during the post-monsoon (October–December) in the far future (FF; 2080–2099) is also projected. The distribution of projected extreme rainfall events shows a decline in moderate or rather heavy events (5 or more) in NF and FF. Further, an increase in higher rainfall category events such as very heavy (5–10) and extremely heavy rainfall (5 or more) events in NF and FF under the warmer climate is found. However, the changes are less prominent during FF compared to the NF. The mean thresholds for extremely heavy rainfall may increase by 1.9–4.9% during NF and FF. Further, the evolution patterns of various quantities, such as tropospheric temperature gradient (TG), specific humidity, and mean sea level pressure, have been analyzed to understand the physical processes associated with rainfall extremes. The strengthening in TG and enhanced atmospheric moisture content in NF and FF support the intensification in projected rainfall extremes over IGP.
Thirteen Coupled Model Intercomparison Project phase 6 (CMIP6) models were employed to simulate mean, maximum, and minimum temperature across 7 homogenous temperature regions of India for both annual ...and summer season (June, July, and August (JJA)). The model fidelity was assessed by comparing them with observed Climate Research Unit temperature dataset. The JJA multi‐model ensemble for the present (1981–2014) suggests large warm biases in the temperature. Although the models could simulate the spatial variability of the mean and maximum temperature over most of the homogeneous regions, they do not compare well for representing the temporal variability. We also found, that although different individual models have strengths and weaknesses in representing spatial and temporal temperature characteristics over India, a few of the models perform better than the others. For example, CNRM‐CM6 could better represent the spatial temperature patterns however they struggle in capturing the temporal variability. HadGEM3‐GC31‐LL, KACE‐1‐0G, and UKESM1‐0‐LL are comparably the best‐performing models for temporal temperature features over India. The annual maximum temperature during far future period is projected to increase by 1.5°C, 2.3°C, and 4.1°C for Socioeconomic Pathways (SSPs) SSP1‐2.6, SSP2‐4.5, and SSP5‐8.5 respectively. At regional scales, JJA mean temperature for SSP5‐8.5 revealed significant increases in Interior Peninsula (3.8°C), Western Himalaya (5.6°C), Northwest (3.9°C), West Coast (3.6°C), East Coast (3.6°C), Northeast (3.6°C), and North Central (3.8°C), highlighting the Western Himalaya's heightened sensitivity. Further, heat wave frequency is projected to rise, with the northern territories (NW, NC, NE, and part of IP) most affected, anticipating week‐long heat waves affecting around 50% of India's population under stronger SSPs. Such unprecedented impacts seem to be less profound in case of abatement scenarios such as the SSP1‐2.6. Our findings support the urgent need for more ambitious mitigation and adaptation strategies to alleviate the public health impacts of climate change.
In near and far future the heat wave over homogeneous temperature zones over India is highly likely to increase. The figure shows the heat wave duration index with reference to the mean of the summer season (where TX > TXnorm +5°C for 7 consecutive days) difference compared to the ensemble mean of the historical period (1984–2014) for SSP1‐2.6 (a), (b), SSP2‐4.5 (c), (d) and SSP5‐8.5 (e), (f) over. The first column shows the difference over the NF period (a), (c), (e), and the second column shows the difference over the FF period (b), (d), (f).
The purpose of this study was to explore the predictors of delayed wound healing and their use in risk stratification for endovascular treatment (EVT) of patients with critical limb ischemia (CLI) ...due to isolated below-the-knee lesions.
Wound healing rates were analyzed retrospectively in patients who underwent successful below-the-knee percutaneous transluminal balloon angioplasty for CLI with tissue loss between May 2008 and June 2013. We also analyzed the independent predictors of delayed wound healing and their use in risk stratification.
The cumulative wound healing rates were 13.9%, 43.8%, 57.7%, and 65.7% at 3, 6, 9, and 12 months, respectively. Multivariate Cox proportional hazards analysis revealed the following as independent predictors of wound nonhealing after initial successful EVT: patients with end-stage renal disease receiving dialysis (hazard ratio HR, 2.6; 95% confidence interval CI, 1.0-6.3; P = .04); albumin level <3.0 g/dL (HR, 2.0; 95% CI, 1.1-3.8; P = .02); C-reactive protein level >5.0 mg/dL (HR, 3.9; 95% CI, 1.6-9.6; P = .003); major tissue loss (HR, 2.1; 95% CI, 1.3-3.4; P = .003); wound infection (HR, 1.9; 95% CI, 1.2-2.9; P = .005); gangrene (HR, 1.8; 95% CI, 1.2-2.8; P = .008); wound depth (University of Texas grade 3; HR, 3.4; 95% CI, 1.4-8.6; P = .009); duration of ulcer (≥2 months; HR, 2.9; 95% CI, 1.0-8.4; P = .048); insulin use (HR, 1.7; 95% CI, 1.0-2.8; P = .04); and lack of below-the-ankle runoff (HR, 1.9; 95% CI, 1.0-3.4; P = .04).
The general status of the patient and the target limb's condition are important predictors of wound nonhealing. Regarding the limb's condition, information on wound depth and duration in addition to wound extent and infection would further enable the selection of suitable CLI patients for EVT. Such information would also enable optimal wound management, leading to successful wound healing and improved limb salvage and survival rates.
Occasionally systemic complications with high risk of death,such as multiple organ dysfunction syndrome(MODS),can occur following multiple bee stings.This case study reports a patient who presented ...with MODS,i.e.,acute kidney injury,hepatic and cardiac dysfunc-tion,after multiple bee stings.The standard clinical findings were then correlated with magnetic resonance imaging(MRI)findings,which demonstrates that MRI may be utilized as a simpler tool to use than other mul-tiple diagnostics.
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